BIOMAT Database Logo BIOMAT Database Logo

Screening programs for congenital hypothyroidism. How can they be improved? 1988

D B Allen, and S A Hendricks, and J Sieger, and D J Hassemer, and M L Katcher, and S L Maby, and S C Duck
Department of Pediatrics, University of Wisconsin, Madison.

High-sensitivity neonatal hypothyroid screening tests are used throughout the country. Because of low specificity, primary care physicians are faced with an abundance of false-positive results that challenge the interpreting physician with clinical, economic, and medicolegal considerations. We surveyed 154 physicians caring for Wisconsin-born infants with the highest newborn-screen thyrotropin values in a two-year period. Our results indicated that (1) confirmation of thyroid normalcy is often delayed beyond 6 weeks of age; (2) there is wide variation among physicians regarding therapeutic goals if hypothyroidism is confirmed; and (3) physicians prefer autonomy in the management of congenital hypothyroidism. Modifications in hypothyroid screening programs may include confirmatory tests by a central laboratory (that distributes filter paper with all abnormal results), provision of a management decision tree for primary care physicians, and a one-time subsidy for a visit to a pediatric endocrinologist. We suggest that these modifications may improve the long-term outcome of hypothyroid infants identified by the screening program.

UI MeSH Term Description Entries
D007037 Hypothyroidism A syndrome that results from abnormally low secretion of THYROID HORMONES from the THYROID GLAND, leading to a decrease in BASAL METABOLIC RATE. In its most severe form, there is accumulation of MUCOPOLYSACCHARIDES in the SKIN and EDEMA, known as MYXEDEMA. It may be primary or secondary due to other pituitary disease, or hypothalamic dysfunction. Central Hypothyroidism,Primary Hypothyroidism,Secondary Hypothyroidism,TSH Deficiency,Thyroid-Stimulating Hormone Deficiency,Central Hypothyroidisms,Deficiency, TSH,Deficiency, Thyroid-Stimulating Hormone,Hormone Deficiency, Thyroid-Stimulating,Hypothyroidism, Central,Hypothyroidism, Primary,Hypothyroidism, Secondary,Hypothyroidisms,Primary Hypothyroidisms,Secondary Hypothyroidisms,TSH Deficiencies,Thyroid Stimulating Hormone Deficiency,Thyroid-Stimulating Hormone Deficiencies
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D008403 Mass Screening Organized periodic procedures performed on large groups of people for the purpose of detecting disease. Screening,Mass Screenings,Screening, Mass,Screenings,Screenings, Mass
D010821 Physicians, Family Those physicians who have completed the education requirements specified by the American Academy of Family Physicians. Family Physician,Family Physicians,Physician, Family
D011795 Surveys and Questionnaires Collections of data obtained from voluntary subjects. The information usually takes the form of answers to questions, or suggestions. Community Survey,Nonrespondent,Questionnaire,Questionnaires,Respondent,Survey,Survey Method,Survey Methods,Surveys,Baseline Survey,Community Surveys,Methodology, Survey,Nonrespondents,Questionnaire Design,Randomized Response Technique,Repeated Rounds of Survey,Respondents,Survey Methodology,Baseline Surveys,Design, Questionnaire,Designs, Questionnaire,Methods, Survey,Questionnaire Designs,Questionnaires and Surveys,Randomized Response Techniques,Response Technique, Randomized,Response Techniques, Randomized,Survey, Baseline,Survey, Community,Surveys, Baseline,Surveys, Community,Techniques, Randomized Response
D003409 Congenital Hypothyroidism A condition in infancy or early childhood due to an in-utero deficiency of THYROID HORMONES that can be caused by genetic or environmental factors, such as thyroid dysgenesis or HYPOTHYROIDISM in infants of mothers treated with THIOURACIL during pregnancy. Endemic cretinism is the result of iodine deficiency. Clinical symptoms include severe MENTAL RETARDATION, impaired skeletal development, short stature, and MYXEDEMA. Cretinism,Myxedema, Congenital,Endemic Cretinism,Fetal Iodine Deficiency Disorder,Cretinism, Endemic,Hypothyroidism, Congenital
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001291 Attitude of Health Personnel Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc. Staff Attitude,Attitude, Staff,Attitudes, Staff,Health Personnel Attitude,Health Personnel Attitudes,Staff Attitudes
D014922 Wisconsin State bounded on the north by Lake Superior and Michigan, on the east by Lake Michigan, on the south by Illinois and Iowa, and on the west by Minnesota and Iowa.

Related Publications

D B Allen, and S A Hendricks, and J Sieger, and D J Hassemer, and M L Katcher, and S L Maby, and S C Duck
Preoperative clinics - how can they be improved?
January 2013, Anaesthesia and intensive care,
D B Allen, and S A Hendricks, and J Sieger, and D J Hassemer, and M L Katcher, and S L Maby, and S C Duck
French screening programs for congenital hypothyroidism.
November 1988, American journal of diseases of children (1960),
D B Allen, and S A Hendricks, and J Sieger, and D J Hassemer, and M L Katcher, and S L Maby, and S C Duck
National community health worker programs: how can they be strengthened?
January 1989, Journal of public health policy,
D B Allen, and S A Hendricks, and J Sieger, and D J Hassemer, and M L Katcher, and S L Maby, and S C Duck
[Prostate cancer screening: How can specificity be improved?]
June 2024, MMW Fortschritte der Medizin,
D B Allen, and S A Hendricks, and J Sieger, and D J Hassemer, and M L Katcher, and S L Maby, and S C Duck
Private practice-health department relationships; how can they be improved?
March 1951, California medicine,
D B Allen, and S A Hendricks, and J Sieger, and D J Hassemer, and M L Katcher, and S L Maby, and S C Duck
Flowmeters. Can they be improved?
October 1967, Anaesthesia,
D B Allen, and S A Hendricks, and J Sieger, and D J Hassemer, and M L Katcher, and S L Maby, and S C Duck
Urgent cancer referrals: how well are they working and can they be improved?
September 2021, The British journal of general practice : the journal of the Royal College of General Practitioners,
D B Allen, and S A Hendricks, and J Sieger, and D J Hassemer, and M L Katcher, and S L Maby, and S C Duck
[How can the prognosis in congenital malformations be improved?].
October 1972, Zeitschrift fur Allgemeinmedizin,
D B Allen, and S A Hendricks, and J Sieger, and D J Hassemer, and M L Katcher, and S L Maby, and S C Duck
How different can they be?
October 1968, Mental retardation,
D B Allen, and S A Hendricks, and J Sieger, and D J Hassemer, and M L Katcher, and S L Maby, and S C Duck
Cord blood thyroxine and thyroid stimulating hormone screening for congenital hypothyroidism: how useful are they?
March 2008, Journal of pediatric endocrinology & metabolism : JPEM,
Copied contents to your clipboard!